We’re all gonna die of cancer

Not this again. CNN is running another article about “X causes cancer!”, where in this case X is coffee. Not regular coffee, just very hot coffee. That is, coffee served at a temperature high enough to cause painful burns might also increase the incidence of esophageal cancer.

Huh. OK. You know, living causes cancer. Epidemiological studies like the one cited are important for identifying possible problems, but your whole life is a great long exercise in risk management where you balance doing things against cowering in terror. We have to consider realistic assessment of risk. So I was going to actually read the study (the short summary given is that an analysis of a thousand studies found that “drinks consumed at very hot temperatures were linked to cancer of the esophagus in humans”, but no numbers were given), but CNN screwed up: their link to the study goes to a paper on the carcinogenicity of pesticides in the Lancet instead. I thought I’d rummage around and try to find it myself, but instead I found this editorial in the latest issue which was pretty good, much better than yet another study that finds a superficial cancer link. So I’m including the whole thing right here.

A month rarely passes by without something being declared unhealthy or carcinogenic. Often, the WHO International Agency for Research on Cancer (IARC) is at the centre of such pronouncements and is duly rounded on to explain the consequences. IARC, however, is not the only agency with responsibility for determining carcinogenicity of products, compounds, or lifestyles, and many countries have their own authorities to inform national policies. Inevitably, such multiple layers of advice, coupled with competing interests, adds confusion to an emotive landscape, undermining the primary objective of risk assessment—cancer prevention. Recent developments in the long-running disputes about the carcinogenicity of talc and glyphosate are notable examples of how these conflicting perspectives can cause problems.

For decades, a possible link between perineal talc use and ovarian cancer has been debated. In 2010, IARC judged this association to be “possibly carcinogenic to humans” (Group 2B)—a classification one level lower than that given to the consumption of red meat. The American National Toxicology Program has not fully reviewed talc as a possible carcinogen, but the American Cancer Society has stated the risk is probably very small, and because of confounding in the data, more research is needed. In the UK, Ovacome (an ovarian cancer charity) have concluded, “we still do not know what really causes ovarian cancer…it is likely to be a combination of many different…factors, rather than one cause such as talc”. Cancer Council Australia has similarly stated that “the evidence is insufficient to conclude that use of talcum powder leads to an increased risk of ovarian cancer”. Despite these conclusions, Johnson & Johnson (J&J) is facing more than 1400 legal claims in the USA on behalf of patients with ovarian cancer. J&J has already lost two cases: one in Alabama (Feb 22, 2016) and another in Missouri (May 2, 2016), and has been ordered to pay damages of US$72 million and $55 million, respectively. These rulings raise concerns about the adequacy of the judicial system to arbitrate complex scientific issues, and more importantly, whether carcinogenic risk is being determined on the basis of public perception rather than on the totality of scientific evidence. Moreover, J&J is not the only manufacturer of talc, which raises the question of whether they are being unfairly targeted simply because they have a large market share and are perceived to be a wealthy multinational company willing to pay out to support their commercial interests.

Financial interests might be at the heart of another long-running dispute: whether glyphosate is carcinogenic. Glyphosate is a broad-spectrum herbicide used in more than 750 products. In 2015, IARC classified the chemical to be “probably carcinogenic to humans” (Group 2A), whereas the European Food Safety Authority (EFSA), the US Environmental Protection Agency, and a joint report by the WHO and UN Food and Agriculture Organization have ruled glyphosate is unlikely to be carcingenic to humans. These conflicting differences of opinion create confusion at a crucial juncture. The European Commission’s Pesticides Committee was due to make a decision in May, 2016, on whether to relicense glyphosate for a further 10 years. If the agent is not relicensed, farmers, food production, and consumers may suffer, say industry campaigners. On the opposing side, on April 27, 2016, MEPs Against Cancer (a coordinated group of European politicians) said relicensing would be “inappropriate” and “unacceptable” given IARC’s evidence. Similarly, many cancer societies, medical groups, and governments across the European Union have also argued against license renewal. How has this confusion come about? First, IARC and EFSA used different methods to assess evidence; second, both organisations had different ways in classifying chemicals containing glyphosate; and, third, scientists claim EFSA’s analyses were flawed and biased by studies funded by herbicide manufacturers, whereas others say IARC’s assessment procedures included conflicted individuals who could have inappropriately influenced scientific discussions.

These latest disputes regarding carcinogen classification highlight the problem of determining reliable findings when data are equivocal and where there are vested interests. They also highlight the difficulties of translating carcinogenicity research into appropriate health policies and recommendations for risk management. Furthermore, there is an equally clear need for a standardised, internationally agreed methodology for carcinogen assessment, alongside ways of presenting results that are easily understood and accepted by all interested parties. Until these objectives are met, carcinogen definition and regulation will continue to be the poor relation to other cancer preventative measures.

That’s reality. Report on that, CNN.


  1. dianne says

    Yeah, yeah, we’re all going to die of cancer, except that most of us die of something else.

    You do realize that if you’re not careful I’m going to start throwing statistics around.

  2. dianne says

    Coffee is not a carcinogen. Very high heat may be a carcinogen via damage to the cells requiring frequent repair with the attendant risk of a mutation at each repair related cell division. Let the coffee cool off a couple of degrees and then drink it and it’ll all be good except for what the caffeine does to your blood pressure.

  3. slithey tove (twas brillig (stevem)) says

    I’ve been wondering about those new Class Action Law Suit advertissments [sic] regarding Talc causing Ovarian Cancer.
    Not having ovaries, nor any talc, I just wonder out of curiosity. Sometimes thinking it might be a serious threat, then reading that pullquote above making it sound like a straw being grasped by desperate cancer sufferers. Confusing correlation for causation.
    When the data is collected in an ex post facto reverse correlation style [forgot the official , term for it]
    EG: OF the group of people with malady X, most were exposed to substance Y. Therefore exposure to substance Y increases ones risk of acquiring malady X. QED lets sue of the providers of substance Y.
    uh huh.
    how about: let’s do a proper statistical analysis of a larger population distribution.

  4. freemage says

    They aren’t understating the legal interests in this sort of half-baked research. My workplace keeps the TV on during my lunchbreak in the cafeteria, and about a third of the commercials at that hour are lawyers advertising for personal injury cases and/or “Product X is associated with Disease/Disorder Q” lawsuits. Many of the personal injury lawyers will now stick a blurb at the end of their regular commercials saying, “Now handling ovarian cancer talcum powder claims” (that’s literally one I’ve heard this week).

  5. dianne says

    Ovarian cancer is caused by ovulating too much. Can we sue every fundamentalist and “prolifer” who lobbied against access to hormonal birth control (which reduces ovulation and ovarian cancer risk)?

  6. euclide says

    The other thing that I found alarmist is that we are only given the relative risk of any behavior

    Like doing X increase your risk of that type of cancer of 40%

    But the base risk is never given.

    If the base risk is 20%, a 40% increase is substantial but if the base risk in 1 in 10 billion, even a 100% increase is not worth worrying.

  7. says

    Every time I hear about the latest ‘X causes cancer!’ scare, it takes me right back to the Great Cyclamate Panic of 1970. Holy shit, you didn’t hear about anything else. ‘Cancer in rats! Cancer in rats!’ People were pouring out cases of soda, flushing artificial sweeteners, swearing off this, that, and the other. New packaging was issued for Kool-aid and like products with a prominent “no cyclamates”, same with a lot of other products too. The FDA has never lifted the ban on cyclamates either, even though there’s been further research debunking the early stuff.

  8. Ed Seedhouse says

    They never stopped selling cyclamate up here in Canada. Good thing too, because they it’s by far better tasting than most other sugar substitutes and has fewer side effects than most, too. I call it the Real Fake Sugar.

  9. Joshua Kosman says

    Last year she had gone to a doctor, who had looked at her throat and a mole on her back, studying them like Rorschachs for whatever he might see in them. He removed the mole and put it floating in a pathologist’s vial, a tiny marine animal. Peering in at her throat, he said, “Precancer” — like a secret or a zodiac sign.

    Precancer?” she had repeated quietly, for she was a quiet woman. “Isn’t that … like life?”

    — Lorrie Moore, “Like Life”

  10. lesherb says

    I stopped using talcum powder more than 20 years ago because I had heard/read somewhere about it causng urogynocologic problems. Now I use powder made with corn starch..I guess until that is deemed carcinogenc.

  11. rrhain says

    I tried reading up on the talc/ovarian cancer thing when I started seeing those lawsuit ads (“If you or a loved experienced death…” Why yes, I died…I’m gonna sue!) and the best thing that I could find was that they were thinking it is akin to the asbestos/lung cancer connection: The talc is an irritant that the body is damaged by and the inflammation, damage, and repair processes lead to tumor formation.

    But I was a bit concerned about how the talc could get to the ovaries. Now, I could think of various processes involved (for example, some sort of capillary action or the talc being suspended in the fluids of the uteral tract that then permeate etc.) After all, yeast infections and the like do happen and can cause problems. And sperm, clearly, gets its way up there since fertilization often takes place in the Fallopian tubes.

    But those are organic in nature. My (albeit limited) understanding is that the uteral tract pushes (with various intensity) out. In order for the sperm to get there, they have to swim against the muscular contractions. They have to penetrate the mucosal plug at the cervix. Yeast is alive, too, and thus has ways to actively spread even if not via an actual motor pushing it.

    Anybody have any idea how talc would get up to the ovaries?

  12. karmacat says

    Dammit. Now, I’m going to have to stop burning my throat and esophagus with really hot coffee everyday. Because I’m only going to stop because I will get cancer rather than stopping because it fucking hurts. These people are ridiculous

  13. neverjaunty says

    They aren’t understating the legal interests in this sort of half-baked research.

    They aren’t, but in the opposite direction you’re looking.

    There is an entire, very well-funded industry of ‘doubt science’ which takes normal, appropriate scientific caution about causation and twists it into something that can be used to evade liability. Tobacco companies did it for years, and industrial polluters (including the asbestos industry) have happily copied their playbook. (Part of that playbook, by the way, is fighting tooth and nail to keep out evidence of the company’s own, not-vetted-by-expensive-lawyers internal memoranda talking about the company’s knowledge of the danger, which is one thing that really killed Johnson & Johnson in the talc litigation.)

    Blaming lawyers here is like blaming the ravens on a battlefield for the slaughter.

    Part of that playbook, by the way

  14. madscientist says

    The WHO has been thoroughly infiltrated by dimwits with a political agenda. For at least the past 15 years so many counter-factual claims have been made that I now have no respect whatsoever for the WHO and refer to the organization as Vood-WHO.